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Utah rates for HCPCS Q2053

Brexucabtagene autoleucel, up to 200 million autologous anti-CD19 CAR positive viable T cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$567,593.35 / $567,593.35 / $567,593.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $587,165.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,720.00 / $489,720.00 / $586,740.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00